Individual
CAROLYN G KOCHERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3218 DAUGHERTY DRIVE, SUITE 110, LAFAYETTE, IN 47909-3997
(765) 446-5055
(765) 446-5057
Mailing address
3218 DAUGHERTY DR, SUITE 110, LAFAYETTE, IN 47909-3997
(765) 446-5055
(765) 446-5057
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01031275A
IN
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
01031275A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000585033
ANTHEM PIN
IN
01
—
11559907
CAQH
IN
Enumeration date
03/16/2006
Last updated
12/23/2011
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